Headache and/or Neck Pain in Preadolescents: provoking factors

Sue Weber BSc, DC, MSc

BACKGROUND: Headache and/or neck pain occur commonly in preadolescents. Do common daily activities provoke headache or neck pain and are these the same for both conditions?

OBJECTIVES: To establish if common daily activities provoke neck pain and/or headache in preadolescents and if the provoking factors are the same for each of these conditions.

DESIGN: A cross-sectional observational study among pre-adolescent students in Sweden.

METHODS: Students from a Swedish municipal school (n=131) aged 10-13 years were asked to participate in a study about neck pain and/or headache. Each student was given a consent form to take home to be signed by their parents. All students completed a questionnaire in the classroom. A section of the questions listed possible provoking factors. Students were asked if they get head and/or neck pain when they: read for a long time, sit at the computer for more than 2 hours, participate in sports where they strain themselves, eat something they are allergic to, or move their head or neck in a certain way.

RESULTS: Of the 131 children, 40% (n=52) complained of neck pain/headache. Prolonged static postures initiated or exacerbated neck pain and/or headaches by the students reporting symptoms, specifically, prolonged reading (42%, n=22) and prolonged computer use (44%, n=23). Twenty-seven percent (n=14) of the children with symptoms reported that moving their neck could initiate or exacerbate their neck pain and/or headaches. The responses were also looked at in groups of students with headache, those with neck pain and those with neck pain and headache. Prolonged reading was them most common answer for initiating neck pain (n=9), it commonly initiated headache (n=7)as well as neck pain and/or headache (n=4). Sitting at the computer for more than 2 hours was the most common initiating factor for headache (n=9) and the second most common answer for neck pain (n=5). Moving the head or neck in a certain way was the most common initiating factor for headache (n=6) and common among those with neck pain and/or headache (n=5), but not so common among those with neck pain (n=2). Sports most commonly initiated headache (n=4).

CONCLUSIONS: Prolonged static postures were the most common initiating factors for headache and neck pain in preadolescents. Considering students spend increasing amounts of time statically, it is appropriate to make available advice on proper ergonomics while reading and using the computer. It is appropriate to discuss limitations of computer use for preadolescents. Students having both neck pain and headache found that moving the neck or head initiated symptoms. This is a common finding in adults with cervicogenic headache. This group of children should be screened for cervical joint dysfunction as appropriate treatment of the joints may resolve the headache and neck pain.